Had chinwing yesterday, have the feeling it's WAY too big

[ben from UK]

I had custom jaw implants before, but these turned out too big. So i had the jaw angles removed, but the chin implant and sides of the chin implants were left in. This created a bit of disharmony, with the chin a bit too big compared to the jaw area. Furthermore, the jaw muscles contracted upwards as a counter reaction on the distress caused on the muscles, leaving a bit of an 'empty space' just right under the jaw muscles and the lower border of the jaw. You can see the phenomenon here: https://www.ncbi.nlm.nih.gov/pubmed/19944991

I decided to do a CW to adress this problem , and bring back the harmony in the face.

I did the CW yesterday, and i know you have to way a couple of weeks before the swelling is gone, but i saw the resultst just after the procedure, when the swelling didn't yet kicked in, and it looked WAY too big, even bigger than the jaw implants. Jaw implants obviousy cause way more swelling. The 2nd reason i think it will turn out too big (again), is that the surgeon just right after the surgery came to see me and told me the end result might not be as expected due to the excess fat i have( i know i have a bit of excess fat in the space due to not sporting the last couple of weeks, but i'm not a fat person, so a little bit op sport and i'm a bit leaner. but there's a difference between lack of definition because of a bit of too much soft tissue and something that is just too big. And this looks way too big. I already have experience with the jaw implants and i just can feel it when something is too big.This is my intuition. Also, the surgeon toldd me that if i want to do a revision it can be done within 3 months, just after surgery. Why is he telling me these things just after surgery, it's like he's already expecting it to be too big.

I don't understand. We discussed this thoroughly, that i only wanted very natural, subtle changes. He also said that he certainly didn't want to lower the jaw/jaw angle too low, because it would look unnatural/almost comical. And yet it seems that is exactly what he did. I know people are going to say 'wait a bit, you'lll see the endresultst later', and part of me wants to believe this, but like i said, just after i had the procedure for jawimplants, the swelling did not yet kick in, and it turned out the result right after the jaw implant procedure (the surgeon showed it to me before putting the bandage back on) was just like the end result after the swelling was gone (7 weeks later).

So i'm distressed right now, and i'm almost already hoping for a revision CW if that's even possible. Especially because the surgeon was talking about revision or doing another plastic surgery after things settle down (but maybe he was talking about something else).

I'm hoping that if the jaw angle is too low i can raise the jaw angle again by cutting the lower boarder and raising it again. I hope this is possible. My intuition says the jaw angle is way too low. I really don't need so much lowering it seems. I opted for small subtle changes, based on my experience with the jaw implants. I maybe ended with something that's even bigger than the previous jaw implants.

Anyone experience with revision CW?

[kavan]

It sounds like the whole custom jaw complex with front chin, lateral chin and rest of mandible was too big for your liking. But then you left the CHIN part in there which left disproportion to the rest of the mandible. So, if you went into the next surgery with chin area that looked TOO BIG or out of proportion with the rest of your jaw and because you removed just the jaw area part and not the chin, the doctor may have made the chin wing proportional to the rest of your big chin which again, is going to be too big for you.

That or it's just volume from all the numbing fluids they put in there that you saw. Only time will tell.

[ben from UK]

It sounds like the whole custom jaw complex with front chin, lateral chin and rest of mandible was too big for your liking. But then you left the CHIN part in there which left disproportion to the rest of the mandible. So, if you went into the next surgery with chin area that looked TOO BIG or out of proportion with the rest of your jaw and because you removed just the jaw area part and not the chin, the doctor may have made the chin wing proportional to the rest of your big chin which again, is going to be too big for you.

That or it's just volume from all the numbing fluids they put in there that you saw. Only time will tell.

The chin and jaw area was slightly too big, not a very big problem. The jaw implant was 7 millimeter, but the chin wing was 9 millimeter lateral + lowering jaw with 9 millimeter. That is just insane, looking back. I'm not a technician and i don't know how much width and lowering is needed with a chin wing, cause i'm not familiatr with this procedure. I trust a surgeon to know exactly till how far he can go with a surgery. He says to me before the surgery: I can see exactly till how far i can go during the surgery. Then after the surgery he tells me things might not be the same results as was planned, because of ecess soft tissue, which is just not true. It looks like he went overboard and then backpaddled on what was promised: natural and subtle results. I almost sure i will end up with a face that is way too dispropotional. Also, why doing approximtely the same size of CW while the problem in first place was caused by sometjing that size or even slightly less. This is what I'm thinking about now, and maybe i should have adressed it before, but as a client i just don't know how much mm there must be compared to an implant.

The only thing that is positive is that the 'empty space' under the jawmuscle is filled because the bone is pulled in a lateral way. But the lowering of the jawangle seemed to be a disaster and not needed at all (maybe only one or 2 millimeter, but 9 millimeter seemed to look way too unnatural/comical and hurting the overall harmony.

I don't know how fast a revision can be done. As the bone didn't close yet, is it possible in special occasions to do the revision just after the initial surgery, or not? I might be wrong but i trust too much on my intuition and the result just after the procedure to know this will not be a disired outcome.

[kavan]

Well, since it looks like you are posting from a geo local in vicinity of where chin wings are done, (if that's the case), then you should be near by enough to just ask him in person what and when he can do next ASAP. 9mm lateral flare out + 9mm drop down is significant. Does your hip hurt from the harvest?

[Lazlo]

post before and after pics. you can blank out the rest of your face.

[ben from UK]

My hip doesn't hurt much, i can walk normally. There will probably be a scar tissue on the area where the hip graft is taken, just under the belly, but i don't really care about that. Also, i had numbness of the lip, but it seems to deminish since a couple of hours. I have not much pain, if you can even call it pain.

I just worry about it being way too much. One othere reason to think this, is that swelling with jaw implants was way more, and this is less swelling but seems even bigger than during the jaw implant swelling. So something seems not right.

I came to do this procedure exactly for the reason that the implant was too big and i needed far more subtle changes to retain a natural harmonious appearance. I know that some people want heavy changes, and maybe it works for their faces, but not with my face. I have no big skull and also no big deficit in the lower half area. So a subtle change is what i definately need. So making the jaw area as big or even bigger than before, is creating the same problem all over again, if not a bigger problem seeing the size of the CW. The problem has been explained many times, 3d scan of the implants were send + pics were send. So if it stays like that, it's a very disappointing result. One of the surgeons i talked to after the jaw implants said it was way too big, and also added you can't exceed certain parameters when it comes to aestethics. You go overboard and you'll look unnatural, and in the worst case like a freak. His words are going through my mind after this cw as well. He's very right. Maybe a little bit too cautious, but never goes overboard as well. Unfortunately he didn't do CW. 

 
People always talk about patience, but usually, just after the surgery, when the swelling haven't yet kicked in, is approximately what the end result will be, at least with the jaw implants. I have filmed the result just after the jaw implants and compared the result with after a couple of weeks of swelling, and it was pretty much the same: both too big. Swelling of jaw implants began 2-3 hours, maybe 4 hours after the surgery and the peak of the swelling was 4-5 days after the surgery. The swelling was gone for 90 percent after 7-8 weeks. So if it's too big by then, you can almost be sure it will be too big after half a year as well. It's not nice to have an implant that is too big, cause it can give a 'bloated' appearance.

[ben from UK]

post before and after pics. you can blank out the rest of your face.

Pics without full face don't say much to me. I see blanked out faces with implants on google search, but i posted a blanked out face once on a forum with only lower half of the face after implants (although it wasn't high resolution, and a bit further away) and people said it looked good. While it was obvious in real life it was too big, which was admitted by the surgeon,without me even starting about it. Besides, with all due respect, and i understand that pics are very important, but i just don't like posting my pics on the net - blanked or not.


The swelling of the CW seems to have past its peak - or maybe it's the peak. Feelings in lip and under my lip seems to slowly coming back (but i won't draw too much conclusions about this yet, though that seems positive). I had a very small area at my left side between lower board of jaw and nerve, so the risk of damage was higher than with someone who has more space, because of the tiny space. The numbness is comparable to going to a dentist.

If you wouldn't know it was a chin wing, you would think it was an easy procedure: minimal pain, numbness diminishing, et cetera. But it is probably no easy procedure and they have to cut from the beginning of the jaw all the way around the chin back to other side of the jaw. Jaw implants are probaly a bit easier, but the difficulty with implants is that you have to put them under the masseter without seeing how exactly the end result will be. So it'will always be a bit of a gamble of how ig they must be. With CW, the surgeon probably can see during the surgery how it will look like. That's why it surprises me it seems to look way too big.
Combined with the fact the surgeon begins to talk about the size just after the surgery, makes me think he feels it's going to end up too big.

Having experienced both procedures, the only thing i want to say is be carefull. I can't stop thinking that some good results have to do with luck as well. It's very difficult to predict what the results of a procedure will be, and most results are probaly subpar, mostly due to surgeons going overboard, so watch out for this.If you have a normal face, be subtle with tha changes you want. But if you are way too subtle, of course not much will change.

[kavan]

Swelling would tend to be more with a bone CUT and a graft put in there...more than with custom implants and if you just had it yesterday, swelling can hit its MAX on day #3.  If you are in a recovery ward with access to the doctor, ask him more questions and report back.

[ben from UK]

Swelling would tend to be more with a bone CUT and a graft put in there...more than with custom implants and if you just had it yesterday, swelling can hit its MAX on day #3.  If you are in a recovery ward with access to the doctor, ask him more questions and report back.

I'm not in a recovery ward, thanks (will speak the surgeon monday, but he seems defensive). Swelling seems less than jaw implants. Could be due to the fact jaw implants (at least the ones used by American surgeons) take alot of space in the face (whole area underneath the masseter), and custom jaw even more (look at the pics of implants and you see alot of areas covered with blue, compared to CW, which is only lower peace of lower jaw. Also, the masseter has to be pulled with implant, in order to place the implant, and there is no good blood flow with silicone, causing things to heal much slower. So, maybe you're right and swelling of CW will be much more, but until now swelling of jaw implants seems more (balloon face)

[ben from UK]

By the way, alot of useless areas are covered with implants it seems. I see pics of custom implant areas between chin and jaw angle going way up, which isn't needed.

I'm pretty sure implants can better some faces if there's subtle improvement and you don't do it too much times (revision - although revision percentage is something like 35%). It will probably always look unnatural though, cause of scar tissue that forms around it instead of being part of the body and bloodflow.

[ODog]

sorry this happened. I also am going to do a CW for subtle changes. I hope the same doesn’t happen to me. Can I ask who your surgeon was ? The only thing you can do now my friend is wait and be firm with the surgeon about your wanting a revision. That’s very disappointing he went too big when you not only specifically asked for subtlety, but you experienced first hand implants that were too big - you think the point would be driven home.

So he said the reason he went big was because of excess soft tissue? This variable should’ve been discussed beforehand.

[ben from UK]

sorry this happened. I also am going to do a CW for subtle changes. I hope the same doesn’t happen to me. Can I ask who your surgeon was ? The only thing you can do now my friend is wait and be firm with the surgeon about your wanting a revision. That’s very disappointing he went too big when you not only specifically asked for subtlety, but you experienced first hand implants that were too big - you think the point would be driven home.

So he said the reason he went big was because of excess soft tissue? This variable should’ve been discussed beforehand.

Thanks for your support. Although i can analyze things rationally, all kind of emotions go through my body: anger, anxiety, dissappointment, insecurity, et cetera.

but you experienced first hand implants that were too big - you think the point would be driven home.

Absolutely. I can blame myself but what do i know about the sizes of CW? Now i know, in case of my face. Waiting is a hell of a process. Rollercoaster emotions and i noticed people act even more nagitive on unnatural results than on ugy faces. Again, i'm talking about my face. So i probaly have to go through the same sh*t all over again, but even worse.

I'd rather not name the name of the surgeon as i still have to speak to him on monday (its in switzerland). I lost my patience now, after the bad experience with implants. I won't accept s**t anymore. I'm angry but trying to control my anger.

I hope the same doesn’t happen to me

It probably depends on the face as well. I can say for sure that some results i saw of CW gave a more 'full/bloated' result instead of sharpness. Some results of CW were fantastic though. But that goes for implants as well. I saw extremely good implant results, especially from Dr. Neo in Rotterdam (he doesn't do custom implants, only jaw implants and chin implants). His results were by far the best results i saw. He's selective in his clients though and generally not a nice man. But you can't have the ideal guy i guess. If he think there's 'nothing wrong with your face', he will usually not do anything.Other surgeons like Eppley do everything a client asks. Dr. Y. is more subtle and  seems to take alot of times to design the implant. He has eye for detail. Details are important. You don't want to end up with something that is too big, cause it will have an impact on the harmony ofthe face, especially if you don't have the typical bite problem. Some people think too easy about the size of implants and CW's. They think: the bigger the better. I can undersatand this logic. Now i know it's not true in most cases. Of course, if you're already good looking, it's more difficult to make you ugly than when you have an average or slightly above average face. But even then, you might end up with a face that is too bloated, or the inverse: something so subtle it doesn't change much if not anything.

So he said the reason he went big was because of excess soft tissue? This variable should’ve been discussed beforehand.

He talked about it just after the surgery. That is, i personally brought it up before the surgery, that i had to lose a bit of weight for a more lean face, but after that it was all said and discussed. No need to bring it up again after the surgery, saying 'things didn't went completely as expected/planned'. When surgeons begin to talk like this, i know they're trying to search for excuses. Because i also got exactly the same vibe as from the surgeon from the implant. He began to say 'i don't think it's too big' just after the surgery, when taking the bandage off. When a surgeon says something like that, without me asking about it, it means: d*mn, it's probly a bit too big, i hope he will accept it, or: i don't want to admit i went overboard, risking a refund or in the worst case a judicial procedure. He had to admit it was too big 2 months later.

This surgeon said it's all about definition. Yes, definition is important, but having experience i know it's also about things not being too big (again: for my face, i saw a girl with almost no jaw at all, adding more than 1 cm with CW and she looked great). I have a strong feeling he went overboard/made a mistake. If that's the case, he needs to revise it. There's no discussion about it for me if that's the case. I don't know when that could be possible with CW. If he says it could be done within a week due to the bone still not being healed, it would be great - but i doubt that is the case, as you normally have to wait 3-6 months with implants and with CW i hear even 1 year.


By the way, this surgeon said, after i explained i had a bad experience with the surgeon from the implant: 'Every patient gets the surgeon he deserves'. Very strange remark, cause it is true, but it is not something you should say. Also, if it is true - and it's probably true - it means he himself is as bad as the previous one. And by creating it too big again, yes, i got a bad surgeon again, so the statement proves to be true again. But he must solve his mistake.

A client might get the surgeon he deserves, but a surgeon also gets the client he deserves. And i won't accept bs anymore.

[ben from UK]

sorry this happened. I also am going to do a CW for subtle changes

I don't know which surgeon you have. The surgeon is important. I usually attract the money driven ones. The reason is i have not a lot of patience. Some good surgeons don't react as fast as the moneydriven ones. I should have more patience. Yes, you get the surgeon you deserve.

The most ethical ones are very strict in accepting clients.

[ODog]

It’s a tricky situation. These procedures aren’t cheap so you want results but subtle, but not too subtle. This is what makes me anxious about doing this procedure eventually. First I am getting a Lefort to correct underbite and crossbite in a few months, tthen CW after because my lower jaw is narrow and angle is high - face shape like  an upside down triangle although it’s not a severe deformity. So I want a wider and dropped down lower jaw but it can’t make me look blocky or like I’ve obviously had work done. I need to entrust the surgeon to strike this balance. I’ve only talked to Dr. Zarrinbal about it.

Why are you saying you had no patience ? I’m sure Even the best surgeons will see you relatively soon if you want it done right away - there’s no need to go with a lower quality one, unless for a lower price but you keep saying patience was your mistake, not beint cheap.

[ben from UK]

It’s a tricky situation. These procedures aren’t cheap so you want results but subtle, but not too subtle. This is what makes me anxious about doing this procedure eventually. First I am getting a Lefort to correct underbite and crossbite in a few months, tthen CW after because my lower jaw is narrow and angle is high - face shape like  an upside down triangle although it’s not a severe deformity. So I want a wider and dropped down lower jaw but it can’t make me look blocky or like I’ve obviously had work done. I need to entrust the surgeon to strike this balance. I’ve only talked to Dr. Zarrinbal about it.

Why are you saying you had no patience ? I’m sure Even the best surgeons will see you relatively soon if you want it done right away - there’s no need to go with a lower quality one, unless for a lower price but you keep saying patience was your mistake, not beint cheap.

The problem is you just don't know if someone is low quality beforehand. But poor results can be an indication, so asking for resultst is always good.

I wanted to go with dr. Z first, but Z. didn't respnd to emails. Same goes for Y. for implants. My lack of patience is a problem.

I can tell now with almost 100% certainty the CW is way too big. I'm so angry and sad about it. It is so big it looks almost comical - based on post op result and experience with the swelling. For me, it is uncomprehensible, as i clearly showed the implant design, talked about it many times. If that design is too big, it means the CW must certainly not exceed it (unless there is some other rule going on with CW, which doesn't seem to be the case).

Surgeons always show their best results, so you only see the top of the iceberg. Of course, it's not easy to perform a good job, but exceeding something that was already too big is an unacceptable mistake, and i'm not here to pay so much money to get a horrible result. You're always the most important client he ever had, even if he operated on thousands. So be cautious. If a surgeon is going to talk about bs right after surgery, usually he's trying to defend his mistake by forehand, or denial kicks in. I heard too many bs from surgeons and my intuition almost never lies with these kind of things. Everyone has a bs detector. Your bs detector is right most of the time. You don't even need to have experience to detect bs. It's intuition. Very few act on it cause we are in a vulnerable position and we need help. Almost every surgeon thinks he's the best of the best. Very low self awareness. We payed alot of money though, and put alot of trustin the hand of another person. We deserve the best we can get.

Subtility is very important and highly underestimated within the community. You lack a couple of mm jaw width? just do a jaw implant bro. Just do a chin wing, just do a sliding genio. If it was so simple, everyone would be happy. Measuring the exact size is a hell of a job. A surgeon needs to have an eye for it, needs to take time to analyze your face and needs to be able to answer your aswers. Some others don't need it. Don't do something if it's not strictly necessary. The risk of exceeding aestethical parameters is way too high. In the end, there is probably a luck factor (and maybe this factor is much higher than we want to admit). Predicting the outcome for 100% is impossible.